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1 Shaping a blueprint for cancer Plymouth Cancer Summit Sean Duffy February 2015

2 Cancer remains our biggest killer 2 million reasons Personal, social and economic impact If we can get it right for cancer, we can get it right for every condition This is why cancer is a priority in the Five Year Forward View Why cancer matters

3 More patients treated More patients surviving Better patient experience than ever before Greater use of effective treatments A lot to be proud of

4 Survival gap with other countries Continuing poor outcomes for some cancers Growing incidence Cancer waiting times Financial context But more to do

5 Radical upgrade on prevention and public health Greater personal control Breaking down institutional barriers New models of care National leadership, local flexibility Shared vision and partnership with the voluntary sector (cancer is an exemplar) Cancer and the Five Year Forward View

6 Tackling late diagnosis Enabling access to the best treatments Supporting people living with and beyond cancer Better outcomes for older people Four big challenges and opportunities

7 GP direct access to tests On average access to tests would make a difference for 6% cases BUT hides 15 – 20% cases where it would (Brain, Pancreas, Renal, Stomach, Testicular and Ovarian cancers) Main tests were CT, Endoscopy and USS

8 Non Obstetric USS – GP access by CCG

9 Non obstetric USS test times Inpatient GP

10 Route to Diagnosis, England 2006-2008 Over half of lung, upper GI and ovarian cancers were patient initiated A & E attendances

11 “The difference between us and them” Increased access to tests Increased willingness to test Easier access to specialist opinion Promote a proactive approach in primary care Explore new models as in the 5YFV Significantly shift early stage at diagnosis from 56% to 66% Making more cancers curable

12 Accelerate Coordinate and Evaluate (ACE) Direct / Access to rapid diagnostics Proactive approach to high risk individuals Pathway for vague symptoms Multi-disciplinary diagnostic centre Increased role for non-GP primary care clinicians Lowering referral thresholds Self-referral Making earlier diagnosis happen

13 We want the best treatments, how can this be encouraged? Clarifying what delivers the best outcomes in terms of survival or experience of care Making strategic decisions based on this knowledge Transparently reporting the outcomes that matter for each health economy and provider of services Access to the best treatments

14 Applying the evidence on volume of surgery and quality of outcomes, networked providers Prescribing better radiotherapy to reduce mortality; greater use of innovative techniques to reduce morbidity Ensuring greater consistency in cancer drug prescribing and innovation in delivery models Making the Cancer Drugs Fund and NICE work for patients and are affordable Treatment priorities

15 More people, living for longer is a good thing! But we need to ensure we support them to live well Recovery package Rehabilitation and reablement Better models of follow-up Coordination with social care Systems should be designed around the needs of patients (not patients forced to adapt to the convenience of the system) Align with LTC agenda Living with and beyond cancer

16 One third of cancer diagnoses now in 75+s, half of deaths NCIN report provides an important baseline Report shows action is required across the pathway Only possible because of the cancer community’s investment in and commitment to intelligence What is the evidence on older people and cancer?

17 Older people are more likely to be diagnosed following an emergency presentation

18 Older people are less likely to receive surgery, radiotherapy or cancer drugs

19 An example: surgery in breast cancer

20 The picture on patient experience is mixed

21 Ambition and clarity of focus Cancer strategy Greater transparency on quality and outcomes Expert and passionate cancer community Enablers

22 A shared vision of how to address each of the four challenges Local leadership and ownership of cancer outcomes High quality intelligence, turned into action Better outcomes, resources used even more effectively What we need to achieve

23 A great deal to be encouraged by A lot more to do We know what needs to happen We all have a role to play in delivering it In summary Earlier diagnosis The best treatments Supporting people Older people

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